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Plast Reconstr Surg. 2020 Feb 06;:
Authors: Chang EI, Liu J
Abstract
INTRODUCTION: The forearm is a common donor site providing thin, pliable workhorse flaps for head and neck reconstruction. There are no prospective studies comparing the donor site morbidity of the radial forearm to the ulnar artery perforator (UAP) flap.
METHODS: All patients undergoing forearm free flaps were included for analysis and followed for a minimum of 1 year. Grip strength, sensation to light touch, temperature sensation and wound healing were assessed.
RESULTS: A total of 98 patients were enrolled (50 radial forearm vs. 48 UAP). There were three osteocutaneous radial forearm flaps performed. The donor site was closed primarily in one radial forearm patient and four UAP patients. The majority of donor sites were resurfaced with full-thickness skin grafts (radial: 40 vs. ulnar: 44), while the remaining were closed with split-thickness skin grafts. Average grip strength compared to baseline measured at 1, 3, 6, 12 months following surgery demonstrated no significant differences. All patients returned to baseline sensation to light touch with no long-term sensory deficits at 1 year. No patients suffered significant changes in temperature sensation or cold intolerance. Seven patients suffered partial skin graft loss (radial: 5 vs. ulnar: 2), all of whom healed secondarily with local wound care. There were no flap losses in the study.
CONCLUSIONS: The radial forearm and ulnar artery perforator flap are equivalent in terms of success and donor site morbidity. Selection of flap should be based on need for pedicle length, flap bulk, concerns with radial or ulnar dominance, and surgeon comfort.
PMID: 32039969 [PubMed - as supplied by publisher]
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